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Would you consider adjuvant immunotherapy for a patient with high-risk Merkel cell carcinoma following definitive surgical resection and adjuvant radiation therapy?
If the patient had N3 nodes, would you add immunotherapy?
Answer from: Radiation Oncologist at Academic Institution
Although there is no level 1 data supporting adjuvant RT in MCC, a relatively recent meta-analysis from an Italian group (Petrelli et al., PMID 31005218) showed that adjuvant RT is associated with a 75% reduction in local and locoregional relapses versus surgery alone, without a reduction in distant...
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Answer from: Medical Oncologist at Community Practice
The ECOG-ACRIN EA6174 study evaluated adjuvant pembro for high-risk stage III MCC. It was closed to accrual in 11/2024, so we await the result of that study to inform the role of adjuvant IO. In the meantime, I agree that surgery followed by adjuvant XRT is the current standard of care, and it may b...
Comments
Medical Oncologist at Onc San Antonio
Thank you! ctDNA as well, perhaps.
Thank you! ctDNA as well, perhaps.
Medical Oncologist at Saint Elizabeth Regional Medical Center
Agree, I think ctDNA data is more compelling than ...
Agree, I think ctDNA data is more compelling than ...
Medical Oncologist at The Ohio State University Comprehensive Cancer Center / James Cancer Hospital and Solove Research Institute
There are MCC caused by polyomavirus, and those th...
There are MCC caused by polyomavirus, and those th...
Answer from: Medical Oncologist at Academic Institution
The STAMP study was read out recently at ESMO 2025 and was reported to be a statistically negative study. A lot of controversy came about the results due to revisions of accrual goals and imbalanced use of RT. Hence, it is a discussion with the patient at the end of the day. Adjuvant use of IO in MC...
Answer from: Medical Oncologist at Community Practice
Well, pending the results of EA6174, there is really no proven standard of care. Radiation is used because this is a tradition, not a proven standard of care. It has not been tested in a randomized study. We ran a pilot study of such patients, comparing nivolumab + radiation (4 patients) versus ipi1...